Splitting pills outside of nurse's scope of practice?

[thesundowner]

New at my hospital - nurses are no longer allowed to split pills. So, if we have a half dose to give, we have to call pharmacy and they have to split it for us/send it up to us (which takes approximately 100 hours because they are so swamped).

Do you split pills where you work?

[silentRN]

Nursing is really becoming dumbed down...

[KelRN215, BSN, RN]

So we will have the pharmacy tech splitting the pills or do you really think with all the pharmacist has to do that it will actually be the pharmacist doint it?

Yup... "for safety reasons we can't let the nurse do it." I had a similar situation when I worked in the hospital... there was one particular med that the MDs were wanting to use a lot during status epilepticus but we didn't stock it on the floor. So, in order to get said med during an emergency, someone would have to stop attending to the patient, put a STAT order in the computer then call the pharmacy to make sure that they knew that stat really meant stat. And then, by the time the "stat" med arrived 45 minutes later, the patient would be intubated in the ICU. But, that was clearly better than stocking it on the floor because nurses aren't capable of reconstituting meds.

We did split our own meds.

[prinsessa]

I don't know if we "can" split our own pills but pharmacy always does it for us. We scan all our own meds so the split pills are sent up in a scanable pouch. I'm not sure how it works on night shift since pharmacy is closed from 11P to 7A.

[RNsRWe, ASN, RN]

Having to give 12.5mg of lopressor PO does get interesting, though, when you're on a unit without a pill splitter- those tiny pills are impossible to split by hand!

You can't get a pill splitter that costs $1.49 in Walgreen's?? I think I'd be bringing in my own at that point.

[RNsRWe, ASN, RN]

RNs can't give IVPs? This policy seems like a special kind of stupid....or else, they assume the nurses are.

[Esme12, ASN, BSN, RN]

It remains within the RN's scope to split pills ans give IV meds.the facilities, however, have the right to institute whatever policy they wish. This is why I always advise to KNOW your facilities policy and procedures.

Now, for making such severe policies that are extremely out of the path of usual and customary.....sounds like they have had a problem in the recent path and are forced into corrective measure by accrediting parties. OR they are very cheap and want to re-package meds or again got in trouble with an accrediting agency for big dosage/waste issues.

Someone Messed Up And they need to take "Immediate corrective action".

[CapeCodMermaid, RN]

We can't split pills in long term care, even the scored ones. We can push a few IV meds but apparently can't be trusted to cut a pill in half.

[NicuGal, MSN, RN]

The split pills were I work also. Then they send them up in the unit dose packages.

[merlee]

I am hysterical laughing about this. Back in the Jurassic age (1970's) I worked on an IV team that did admixture for everything except TPN. Oh, that's right, this was BEFORE TPN!!! We added K to IV BOTTLES (anyone here remember BOTTLES), we mixed all of the IV antibiotics, and then we finally got a laminar flow hood. The pharmacy mixed TPN when we started giving that.

I remember hanging those first few bottles of LIPIDS - - ooooo, scary! That milky white liquid was fascinating.

And now we can't split pills!! I guess I should ask my pharmacist to split my own pills!

[Erikadawn RN]

In Lpn school 4 years ago, we teased our clinical instructor when she told us how they melted down the morphine on a bunsen burner, and drew it up into a syringe. I think she finished nursing school in the early 60's. We would ask her, who was her instructor, Florence Nighintgale. My how times have changed

[That Guy, BSN, RN, EMT-B]

I wonder if this is a byproduct of the nursing schools farming out tons of new nurses. Might not be getting the brightest crayons in the box

[wooh, BSN, RN]

Will they allow you to crush the pills?